Mrs Caroline Suzanne Ellis, NURSE PRACTITIONER is a medicare enrolled "Nurse Practitioner - Family" in Carrizozo, New Mexico. Her current practice location is
710 E Ave, Family Medicine, Carrizozo, New Mexico. You can reach out to her office (for appointments etc.) via phone at
(575) 648-2317.
Mrs Caroline Suzanne Ellis is licensed to practice in New Mexico (license number 81488) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1588486989.
Provider's Profile
Full Name | Mrs Caroline Suzanne Ellis |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 710 E Ave, Carrizozo, New Mexico |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1588486989
- Provider Enumeration Date: 10/28/2024
- Last Update Date: 11/20/2024
Medicare PECOS Information:
- PECOS PAC ID: 7416483912
- Enrollment ID: I20241206003031
Medical Identifiers
Medical identifiers for Mrs Caroline Suzanne Ellis such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1588486989 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LF0000X | Nurse Practitioner - Family | 81488 (New Mexico) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Caroline Suzanne Ellis allows following entities to bill medicare on her behalf.
Entity Name | Presbyterian Healthcare Services |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1104802354 PECOS PAC ID: 9234041708 Enrollment ID: O20031103000603 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Caroline Suzanne Ellis is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mrs Caroline Suzanne Ellis, NURSE PRACTITIONER Po Box 26666, Albuquerque, NM 87125-6666 Ph: (575) 740-7449 | Mrs Caroline Suzanne Ellis, NURSE PRACTITIONER 710 E Ave, Family Medicine, Carrizozo, NM 88301-0008 Ph: (575) 648-2317 |
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